372 research outputs found

    Comparative analysis of tunisian sheep-like virus, bungowannah virus and border disease virus infection in the porcine host

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    Apart from the established pestivirus species Pestivirus A to Pestivirus K novel species emerged. Pigs represent not only hosts for porcine pestiviruses, but are also susceptible to bovine viral diarrhea virus, border disease virus (BDV) and other ruminant pestiviruses. The present study focused on the characterization of the ovine Tunisian sheep-like virus (TSV) as well as Bungowannah virus (BuPV) and BDV strain Frijters, which were isolated from pigs. For this purpose, we performed genetic characterization based on complete coding sequences, studies on virus replication in cell culture and in domestic pigs, and cross-neutralization assays using experimentally derived sera. TSV forms a distinct phylogenetic group more closely related to Pestivirus C (classical swine fever virus, CSFV) than to Pestivirus D (BDV). In contrast to BDV and BuPV, TSV replicates by far more efficiently on ovine than on porcine cells. Nevertheless, pigs were susceptible to TSV. As a consequence of close antigenic relatedness of TSV to CSFV, cross-reactivity was detected in CSFV-specific antibody assays. In conclusion, TSV is genetically closely related to CSFV and can replicate in domestic pigs. Due to close antigenic relatedness, field infections of pigs with TSV and other ruminant pestiviruses can interfere with serological diagnosis of classical swine fever

    Mannheim Peritonitis Index (MPI) and elderly population: Prognostic evaluation in acute secondary peritonitis

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    Introduction. Acute Secondary Peritonitis due to abdominal visceral perforation is characterized by high mortality and morbidity risk. Risk stratification allows prognosis prediction to adopt the best surgical treatment and clinical care support therapy. In Western countries elderly people represent a significant percentage of population Aim. Evaluation of Mannheim Peritonitis Index (MPI) and consideration upon old people. Patients and methods. Retrospective study on 104 patients admitted and operated for \ue2\u80\u9cAcute Secondary Peritonitis due to visceral perforation\ue2\u80\u9d. MPI was scored. In our study we want to demonstrate efficacy of MPI and the possibility to consider older age an independent prognostic factor. Results. Mortality was 25.96%. Greatest sensitivity and specificity for the MPI score as a predictor of mortality was at the score of 20. MPI score of 22. Patients with MPI score 17-21 had 0.46 times lower risk of mortality compared to patients with MPI score >21. In the group of patients with MPI score of >20 the mortality rate was 48.5% for patients older than 80 years old and 12.1% for younger patients (p < 0.005); in the group with MPI score of < 20 mortality rate was respectively 8.4% and 1.4% (p < 0.005). Discussion and conclusions. Data confirm the accuracy of the test. MPI score and age over 80 years old resulted independent predictors of mortality at multivariate analysis

    Cardiovascular comorbidities and pharmacological treatments of covid-19 patients not requiring hospitalization

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    Introduction: The Coronavirus disease 2019 (COVID-19) outbreak is a whole Earth health emergency related to a highly pathogenic human coronavirus responsible for severe acute respiratory syndrome (SARS-CoV-2). Despite the fact that the majority of infected patients were managed in outpatient settings, little is known about the clinical characteristics of COVID-19 patients not requiring hospitalization. The aim of our study was to describe the clinical comorbidity and the pharmacological therapies of COVID-19 patients managed in outpatient settings. Materials and Methods: We performed an observational, retrospective analysis of laboratory-confirmed COVID-19 patients managed in outpatient settings in Naples, Italy between March 9 and May 1, 2020. Data were sourced from the prospectively maintained Health Search (HS)/Thales database, shared by 128 primary care physicians (PCPs) in Naples, Italy. The clinical features and pharmacological therapies of COVID-19 patients not requiring hospitalization and managed in outpatient settings have been described. Results: A total of 351 laboratory-confirmed COVID-19 patients (mean age 54 ± 17 years; 193 males) with outpatient management were evaluated. Hypertension was the most prevalent comorbidity (35%). The distribution of cardiovascular comorbidities showed no gender-related differences. A total of 201 patients (57.3%) were treated with at least one experimental drug for COVID-19. Azithromycin, alone (42.78%) or in combination (27.44%), was the most widely used experimental anti-COVID drug in outpatient settings. Low Molecular Weight Heparin and Cortisone were prescribed in 24.87% and 19.4% of the study population, respectively. At multivariate regression model, diabetes (risk ratio (RR): 3.74; 95% CI 1.05 to 13.34; p = 0.04) and hypertension (RR: 1.69; 95% CI 1.05 to 2.7; p = 0.03) were significantly associated with the experimental anti-COVID drug administration. Moreover, only diabetes (RR: 2.43; 95% CI 1.01 to 5.8; p = 0.03) was significantly associated with heparin administration. Conclusions: Our data show a high prevalence of hypertension, more likely treated with renin– angiotensin–aldosterone system (RASS) inhibitors, among COVID-19 patients not requiring hospitalization. Experimental COVID-19 therapies have been prescribed to COVID-19 patients considered at risk for increased venous thromboembolism based on concomitant comorbidities, in particular diabetes and hypertension

    Moving the target on the optimal adjuvant strategy for resected pancreatic cancers: A systematic review with meta-analysis

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    Combination regimens have shown superiority over single agents in the adjuvant treatment of resected pancreatic cancer (PC), but there are no data supporting definition of the best regimen. This work aimed to compare the efficacy and safety of mFOLFIRINOX, gemcitabine+capecitabine, and gemcitabine+nab/paclitaxel in PC patients. A meta-analysis was performed for direct comparison between trials comparing combination regimens and gemcitabine monotherapy. Subsequently, an indirect comparison was made between trials investigating the efficacy and safety of mFOLFIRINOX, gemcitabine+capecitabine, and gemcitabine+nab/paclitaxel because of the same control arm (gemcitabine). A total of three studies met the selection criteria and were included in our indirect comparison. Indirect comparisons for efficacy outcomes showed a benefit in terms of DFS (disease-free survival)/EFS (event-free survival)/RFS (relapse-free survival) for both mFOLFIRINOX versus gemcitabine+capecitabine (HR 0.69, 95% CI 0.52–0.91) and versus gemcitabine+nab/paclitaxel (HR 0.67, 95% CI 0.50–0.90). No significant advantage was registered for OS (overall survival). Indirect comparisons for safety showed an increase in terms of G3-5 AEs (with the exception of neutropenia) for mFOLFIRINOX versus gemcitabine+capecitabine (RR 1.24, 95% CI 1.03–1.50), while no significant differences were observed versus gemcitabine+nab/paclitaxel. According to our results, mFOLFIRINOX is feasible and manageable and could represent a first option for fit PC resected patients

    Pseudohipoparatiroidismo en niños: manifestaciones clínicas e implicancias del tratamiento

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    El pseudohipoparatiroidismo es una enfermedad hereditaria caracterizada por presentar resistencia a la hormonaparatiroidea que se manifiesta por hipocalcemia, hiperfosfatemia y niveles elevados de PTH. Los pacientes pueden presentar características fenotípicas de osteodistrofia hereditaria de Albright y tener asociadas otras resistencias hormonales. En este trabajo se analizan las características clínicas y bioquímicas de 13 niños afectados de la enfermedad, como así también la implicancia del tratamiento. El diagnóstico temprano, la detección oportuna de resistencias hormonales asociadas y el control periódico de los pacientes,son de relevancia para promover el crecimiento y disminuir las secuelas de la hipocalcemia.Fil: Tau, Cristina Catalina. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; ArgentinaFil: Geniuk, N.. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; ArgentinaFil: Viterbo, Gisela Lorena. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; ArgentinaFil: Guercio, Gabriela Viviana. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; ArgentinaFil: Belgorosky, Alicia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentin

    Cracking behaviour of high-strength AA2024 aluminium alloy produced by Laser Powder Bed Fusion

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    Most wrought aluminium alloys of the 2000 series are difficult to manufacture by laser powder bed fusion (L-PBF) due to the formation of cracks during building. To date, the effects of processing regimes on crack formation are still not well understood. In this study we performed a detailed microstructural characterisation of crack development in the AlCuMg alloy AA2024 to quantify the extent of cracking and porosity arising from a range of different process parameters. Two samples, produced with different build parameters, were selected for in-depth study by scanning and transmission electron microscopy; these had similar low levels of porosity but high (H - 2.6 ± 0.4 mm/mm2) and low (L - 1.5 ± 0.3 mm/mm2) crack densities respectively. Based on distinct morphological features and characteristic length, we differentiate hot cracks from solid state cracks. Hot tears form at high angle grain boundaries and are associated with micron-sized gas pores as well as intermetallic phases in both samples. The solidification and cracking behaviour are modelled with the aid of a Scheil-Gulliver model that includes solute trapping. This approach predicts differences in hot-crack-susceptibilities, due to different solidification velocities, in line with experimental observations. The sample H, of high crack density, also experiences the higher cooling rate, and hence strain rate, which contributes to the greater propagation of cold cracks in the low fracture toughness AA2024. The observation of cracking associated with microporosity and the use of a Scheil-based solidification model, including solute trapping, provide new insights into the complex problem of hot tearing during L-PBF

    Age before stage: insulin resistance rises before the onset of puberty: a 9-year longitudinal study (EarlyBird 26).

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    OBJECTIVE: Insulin resistance (IR) is associated with diabetes. IR is higher during puberty in both sexes, with some studies showing the increase to be independent of changes in adiposity. Few longitudinal studies have reported on children, and it remains unclear when the rise in IR that is often attributed to puberty really begins. We sought to establish from longitudinal data its relationship to pubertal onset, and interactions with age, sex, adiposity, and IGF-1. RESEARCH DESIGN AND METHODS: The EarlyBird Diabetes study is a longitudinal prospective cohort study of healthy children aged 5-14 years. Homeostasis model assessment (HOMA-IR), skinfolds (SSF), adiposity (percent fat, measured by dual-energy X-ray absorptiometry), serum leptin, and IGF-1 were measured annually in 235 children (134 boys). Pubertal onset was adduced from Tanner stage (TS) and from the age at which luteinizing hormone (LH) first became serially detectable (≥0.2 international units/L). RESULTS: IR rose progressively from age 7 years, 3-4 years before TS2 was reached or LH became detectable. Rising adiposity and IGF-1 together explained 34% of the variance in IR in boys and 35% in girls (both P < 0.001) over the 3 years preceding pubertal onset. The contribution of IGF-1 to IR was greater in boys, despite their comparatively lower IGF-1 levels. CONCLUSIONS: IR starts to rise in mid-childhood, some years before puberty. Its emergence relates more to the age of the child than to pubertal onset. More than 60% of the variation in IR prior to puberty was unexplained. The demography of childhood diabetes is changing, and prepubertal IR may be important

    The role of coffee consumption in breast and ovarian cancer risk: updated meta-analyses

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    Background: Coffee consumption in relation to female hormone-related cancers has been investigated but metaanalyses regarding breast and ovarian cancer include studies published up to 2012 with inconsistent results for ovarian cancer. Methods: We conducted two updated meta-analyses of studies published up to June 2016 to quantify the association of coffee intake with breast and ovarian cancer risk with random effects models. We used the dataset developed by the International Agency for Research on Cancer Working Group for Monograph 116 meeting (May 2016). We additionally performed a PubMed search in June 2016. Results: Summary relative risks (RRs) (95% confidence intervals (CI)) for the study-specific highest vs. lowest coffee consumption were for breast and ovarian cancer respectively: 0.97 (0.93\u20131.00, \u3992 5.5%, 40 studies, 76,728 cases) and 1.03 (0.93\u20131.14, \u3992 31.9%, 31 studies, 13,111 cases). For decaffeinated coffee the corresponding RRs were: 1.00 (0.93-1.08, I2 32.2%, 13 studies) and 0.83 (0.71-0.96, I2 about 0%, 9 studies). The association of coffee with ovarian cancer risk was higher among publications before (RR=1.37, 1.12\u20131.69) compared to after 2000 (RR=0.96, 0.86-1.06). Conclusion: Our meta-analyses provide strong, quantitative evidence that coffee consumption is not related to breast cancer risk and appears to be unrelated to ovarian cancer risk

    La tutela dei diritti umani in Europa tra sovranit\ue0 statale e ordinamenti sovranazionali

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    Il Volume si propone di offrire una visione dei sistemi di tutela dei diritti umani esistenti a livello europeo, pur nella consapevolezza che gli argomenti trattati non permettono di delineare un quadro esaustivo delle diverse problematiche. Nella scelta degli argomenti si \ue8 comunque tenuto conto di alcune delle principali questioni che animano l\u2019attuale dibattito scientifico. Nella redazione dell\u2019opera, a cui hanno partecipato diversi studiosi italiani e stranieri, si \ue8 perseguito l\u2019intento di coniugare il rigore dell\u2019indagine critica ad un\u2019attenzione particolare per le esigenze della didattica, al fine di offrire uno strumento rivolto non solo agli operatori giuridici, ma anche agli studenti universitari. In particolare, allo scopo di agevolare l\u2019uso didattico del Volume, si \ue8 ritenuto opportuno articolare l\u2019opera in cinque parti distinte, impiegabili indipendentemente l\u2019una dall\u2019altra ovvero secondo differenti combinazioni
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